腹腔镜治疗中重度子宫内膜异位症术后应用GnRH-a对妊娠的影响

发布时间：2018-08-12 13:51

【摘要】：目的:探讨中重度子宫内膜异位症(EMT)合并不孕患者在单纯腹腔镜术后与腹腔镜术后应用促性腺激素释放激素类似物(GnRH-a)对妊娠的影响。方法:选取2011年1月-2013年12月期间在江西省妇幼保健院收治的中重度子宫内膜异位症(III、IV期)合并不孕症患者144例作为研究对象,根据患者术后意愿分为对照组、观察组。对照组为单纯腹腔镜术后,观察组为腹腔镜术后应用促性腺激素释放激素类似物(GnRH-a)。所有患者术后随访2年,比较两组患者的妊娠率及流产率情况。结果:1年内,观察组的妊娠率45/80(56.25%)高于对照组17/64(26.56%);2年内,观察组的妊娠率47/80(58.57%)高于对照组18/64(28.12%);观察组第1年的妊娠率45/80(56.25%)高于第2年妊娠率2/80(2.5%),对照组第1年的妊娠率17/64(26.25%)高于第2年妊娠率1/64(1.56%);2年内观察组的流产例数7例(15%),对照组3例(16.7%)。结论:中重度内异症合并不孕患者腹腔镜术后应用GnRH-a较单纯腹腔镜术后相比能提高术后妊娠率;在妊娠时间上,无论单纯腹腔镜术后还是腹腔镜术后应用GnRH-a在术后1年内妊娠率较高,1年后妊娠率趋于平稳,因此内异症合并不孕患者争取在术后1年内妊娠,如术后1年仍未妊娠应尽早行辅助生殖技术(ART)助孕。
[Abstract]:Objective: to investigate the effect of gonadotropin releasing hormone analogue (GnRH-a) on pregnancy in patients with moderate and severe endometriosis (EMT) complicated with infertility after laparoscopic and laparoscopic surgery. Methods: 144 cases of moderate and severe endometriosis (stage IIIIV) with infertility were selected from January 2011 to December 2013 in Jiangxi Maternal and Child Health Care Hospital. The patients were divided into control group and observation group according to the wishes of the patients. The control group was treated with laparoscopy alone and the observation group with gonadotropin releasing hormone analogue (GnRH-a). All patients were followed up for 2 years to compare the pregnancy rate and abortion rate. Results: within one year, the pregnancy rate in the observation group was 45 / 80 (56.25%) higher than that in the control group 17 / 64 (26.56%), within 2 years, The pregnancy rate of the observation group was 47 / 80 (58.57%) higher than that of the control group (28.12%), the pregnancy rate of the observation group in the first year was 45 / 80 (56.25%) higher than that in the second year (2.5%), the pregnancy rate of the control group in the first year was 17 / 64 (26.25%) higher than that in the second year (1.56%), the number of miscarriages in the observation group was 15% (7 cases) and that in the control group (3 cases (716.716.%). Conclusion: the pregnancy rate of patients with moderate or severe endometriosis complicated with infertility after laparoscopic operation is higher than that of laparoscopy alone, and the pregnancy time is higher than that of laparoscopy alone. The pregnancy rate of GnRH-a after laparoscopy or laparoscopic surgery was higher within 1 year after operation, and the pregnancy rate tended to be stable after one year, so the patients with endometriosis and infertility were trying to get pregnant within 1 year after operation. If the pregnancy is not 1 year after operation, the assisted reproductive technique (ART) should be performed as soon as possible.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R713

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